BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: EuroQoL Quality of Life Scale (EQ-5D) Year: 1990; revised 1993 Domain: Biological, Psychological Assessment Tool Category: Quality of Life Variations/Translations: The EQ-5D has been translated into a number of languages including Dutch, Finnish, Norwegian, and Swedish. Different language versions are available from the EuroQoL Group Executive Office in Rotterdam, the Netherlands. Setting: Home or clinical Method of Delivery: Self-administration or in-person interview Description: The EQ-5D is a measure of self-reported health outcomes that is applicable to a wide range of health conditions and treatments. It consists of two parts: a descriptive system (Part I) and a visual analogue scale (VAS) (Part II). Part I of the scale consists of 5 single-item dimensions including: mobility, self care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has a 3 point response scale designed to indicate the level of the problem. Part II uses a vertical graduated VAS (thermometer) to measure health status, ranging from worst imaginable health state to best imaginable health state. The extended version of the EQ-5D includes a valuation task which is used only for valuation studies. There is also an optional set of demographic questions (EuroQol Group; McDowell & Newell, 1996; Bowling, 2005). Scoring/Interpretation: Descriptive data from the 5 dimensions of Part I can be used to generate a health-related quality of life profile for the subject. Part II is scored from 0 (worst health state imaginable) to 100 (best health state imaginable). The score from Part II can be used to track changes in health, on an individual or group level, over time (McDowell & Newell, 1996). Time to Administer: Less than 10 minutes Availability: Tests and guidelines available for clinical and commercial use through the EuroQol Group Executive Office. Apply to EuroQol for permission to use. Permission to use generally granted upon request, with no fee for non-commercial users. Software: N/A Website: http://www.euroqol.org/ Quantitative/Qualitative: Quantitative and qualitative Validity (Quantitative): Concurrent validity was assessed by comparing scores from the EQ-5D to scores from the SF-36 and HUI-3 (Health Utilities Index). Correlation with the HUI-3 was reported to be 0.69. Correlation with the SF-36 was reported to be 0.64 for the physical component score and 0.52 for the mental component score (McDowell & Newell, 1996). However, in another study in which the EQ-5D was compared with the SF-36 and the HUI3 in patients with rheumatic disease, correlations with the EQ-5D were found to be slightly lower (range of 0.23-0.55 for the SF-36 and 0.45-0.57 for the HUI-3) (Luo et al, 2003). There has been a report of lack of construct validity, as a study found that the EQ-5D health descriptions did not correlate well with the respondents’ actual health experiences (Insinga and Fryback, 2003). One study reported large ‘ceiling effects’, indicating that the EQ-5D is less sensitive for persons with low levels of perceived ill-health (Brazier, Jones, & Kind, 1993). Much of the information available concerning validity refers to earlier versions of the scale (Bowling, 2005). Reliability (Quantitative): Some studies evaluating test-retest reliability have demonstrated this it is high for both individual items (r = 0.90) and for all health states considered simultaneously (r = 0.86). Kappa values for retest reliability after 7 days were 0.29 for anxiety/depression, 0.40 for mobility, 0.58 for pain, and 0.61 for usual activities (McDowell & Newell, 1996). References: Bowling, A. (2005). Measuring Health: A review of quality of life measurement scales (3rd ed.). New York, NY: Open University Press. EuroQol Group. EQ-5D. Retrieved on Mar. 25, 2009 from http://gs1.q4matics.com/EuroqolPublishWeb/. Insinga, R.P., & Fryback, D.G. (2003). Understanding differences between self-ratings and population ratings for health in the EuroQol. Quality of Life Research, 12, 611-619. Luo, N., Chew, L.H., Fong, K.Y., et al. (2003). A comparison of the EuroQOl-dD and the Health Utilities Index mark 3 in patients with rheumatic disease. Journal of Rheumatology, 30, 2268-2274. McDowell, I., & Newell, C. (1996). Measuring Health: A Guide to Rating Scales and Questionnaires (2nd ed). New York: Oxford University Press. Comments: The EuroQol group, recognizing the methodological problems of the EQ-5D, has worked to improve it (Bowling, 2005).